Alanine transaminase and hemoglobin appear to predict the occurrence of antituberculosis medication hepatotoxicity; findings and implications in Botswana,Expert Review of Anti-infective Therapy

当前位置： X-MOL 学术 › Expert Rev. Anti Infect. Ther. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Alanine transaminase and hemoglobin appear to predict the occurrence of antituberculosis medication hepatotoxicity; findings and implications in Botswana
Expert Review of Anti-infective Therapy ( IF 5.7 ) Pub Date : 2020-12-01 , DOI: 10.1080/14787210.2020.1822735
Boikobo Kesenogile ₁ , Brian Godman _{2,

3,

4} , Godfrey Mutashambara Rwegerera _{1,

5}

Affiliation

ABSTRACT

Objective

Tuberculosis (TB) remains a global health problem, with medications having adverse effects including drug-induced hepatotoxicity. We determined the prevalence of anti-tuberculosis drug-induced hepatotoxicity and associated risk factors.

Methods

Retrospective cross-sectional study in Botswana including TB patients admitted from 1 June 2017 to 30 June 2018. Anti-TB drug-induced hepatotoxicity was categorized according to WHO criteria whereas causality assessment was made according to the updated Roussel Uclaf Causality Assessment Method (RUCAM) scale. The association between hepatotoxicity and included variables was undertaken by binary logistic regression.

Results

Out of 112 patient files, 15 (13.4%) developed hepatotoxicity after an average of 20.4 days from the start of treatment. Grade 3 and 4 hepatotoxicity was found in 66.7% of the cases. According to the updated RUCAM tool, 86.7% of patients were categorized as having possible anti-TB-associated hepatotoxicity. Patients with elevated baseline alanine transaminase (ALT) were more likely to develop hepatotoxicity (OR = 3.484, 95% CI = 1.02–11.90). Patients with normal hemoglobin (Hb ≥ 12 g/dl) were also more likely to develop hepatotoxicity (OR = 4.413, 95% CI = 1.160–14.8).

Conclusion

Overall, normal hemoglobin and elevated baseline ALT levels were significantly associated with anti-TB drug-induced hepatotoxicity. Additional research is needed to explore this association further.

中文翻译：

丙氨酸转氨酶和血红蛋白似乎可以预测抗结核药物肝毒性的发生；博茨瓦纳的发现和影响

摘要

客观的

结核病 (TB) 仍然是一个全球性的健康问题，药物具有副作用，包括药物引起的肝毒性。我们确定了抗结核药物引起的肝毒性的患病率和相关的危险因素。

方法

博茨瓦纳的回顾性横断面研究，包括 2017 年 6 月 1 日至 2018 年 6 月 30 日期间入院的结核病患者。抗结核药物引起的肝毒性根据 WHO 标准进行分类，而因果关系评估则根据更新的 Roussel Uclaf 因果关系评估方法 (RUCAM) 进行规模。肝毒性与包含变量之间的关联是通过二元逻辑回归进行的。

结果

在 112 名患者档案中，15 名 (13.4%) 在治疗开始后平均 20.4 天后出现肝毒性。在 66.7% 的病例中发现了 3 级和 4 级肝毒性。根据更新的 RUCAM 工具，86.7% 的患者被归类为可能具有抗结核相关肝毒性。基线丙氨酸转氨酶 (ALT) 升高的患者更有可能发生肝毒性（OR = 3.484，95% CI = 1.02–11.90）。血红蛋白正常（Hb ≥ 12 g/dl）的患者也更有可能发生肝毒性（OR = 4.413，95% CI = 1.160–14.8）。